The present invention relates to the regulation of intraocular pressure (IOP) during and immediately after eye surgery. IOP can increase during and following both invasive eye surgery, for example, cataract surgery, glaucoma surgery and vitrectomy, and non-invasive eye surgery, for example, non-invasive laser surgery.
In the prior art, systemic IOP lowering agents such as carbonic anhydrase inhibitors, acetazolamide, and the like, as well as systemically administered hyperosmotic agents such as mannitol, glycerin, and the like, have been used for treating the IOP increase occurring during and after surgery. More recently, so called clonidines or substituted phenyliminoimidazolines have been employed as topical eye drops applied preoperatively in order to provide decreased IOP over a relatively short period, i.e., 1-24 hours prior to the surgical procedure, followed by subsequent application after surgery for controlling post-operative IOP. See U.S. Pat. No. 5,212,196.
The present invention provides another solution to the problem of maintaining normal or below normal IOP during and immediately after eye surgery without the need for topical application of an IOP reducing agent in the form of drops or ointment prior to eye surgery and/or immediately after eye surgery.
In one embodiment of the present invention, a prostaglandin-like IOP reducing agent of the type providing extremely low side effects is infused into the eye during surgery as part of a conventional ophthalmic surgical infusion or rinsing solution.
In a preferred embodiment of the present invention, the active agent is a 13,14-dihydro-15-keto prostaglandin having an extended straight chain omega chain, or having a shortened omega chain containing a ring.
In preferred embodiments at present, isopropyl unoprostone, which is 13,14-dihydro-15-keto-20-ethyl PGF2xcex1 isopropyl ester (a docosanoid), 15-keto-latanoprost, which is 13,14-dihydro-15-keto-18,19,20-trinor-17-phenyl PGF2xcex1 isopropyl ester, or 13,14-dihydro-15-keto-travoprost, which is 13,14-dihydro-15-keto-17,18,19,20-tetranor-16-(m-trifluoromethylphenoxy)-PGF2xcex1 isopropyl ester, is used as an active drug. In a particularly preferred embodiment at present, the active agent is isopropyl unoprostone and/or 15-keto-latanoprost. In another preferred embodiment, the ophthalmic infusion is an artificial aqueous humor. In still another preferred embodiment, the active drug is a PGF type compound.